| While many outcomes after traumatic brain injury (TBI) have been systematically investigated, the most basic of all outcomes—survival—has been neglected; especially for individuals completing initial inpatient rehabilitation and surviving to one-year post-injury. The purpose of this study was to investigate mortality in a cohort of 1,946 individuals with TBI completing inpatient rehabilitation in one of 14 National Institute on Disability and Rehabilitation Research-funded TBI Model Systems of care. The study hypotheses were: (1) TBI increases mortality and decreases life expectancy in individuals with TBI completing inpatient rehabilitation and surviving to one year post-injury, relative to the general population; (2) the causes of death in individuals with TBI completing inpatient rehabilitation and surviving to one year post-injury do not match the causes in the general population; deaths related to circulatory, respiratory, seizure and external causes will be higher than expected; and (3) the risk of death is greater in certain TBI subgroups; those who are less functional, were older at injury, and alcohol users.; Results indicate that individuals with TBI were twice as likely to die compared to individuals in the general population of similar age, gender and race, resulting in an estimated average life expectancy reduction of seven years. Individuals with TBI were 60 times more likely to die of seizures and two and a half times more likely to die of respiratory-related conditions compared to individuals in the general population of similar age, gender and race. Within the TBI population, the strongest independent risk factors for death after one-year post-injury were older age and less education at injury and greater disability at rehabilitation discharge. This information is important to guide decision-making for treatment, utilization of limited medical resources, and planning for ongoing health care needs and lifetime planning. |
